35-Year Experience with Surgical Treatment of Hidradenitis Suppurativa

AbstractBackgroundHidradenitis suppurativa is a painful and disfiguring chronic inflammatory condition affecting both men and women. Medical treatments, such as antibiotics and immunosuppressive agents, are often ineffective. Over time, patients can suffer from recurrent abscesses, chronic purulent drainage, scarring, and contractures that can only be corrected by surgical excision. There is no agreement, however, on the best way for the surgeon to manage this condition. The purpose of this review is to describe the results of surgical treatment of this condition in a large cohort of patients managed by local excision of hidradenitis, healing by secondary intention and reoperation as needed.Study designA retrospective review was conducted of all patients operated on by the author for hidradenitis over a 35-year period. Specific data abstracted included patient age, weight, admission, length of stay, wound size, type of wound care, number of post-op visits, time to heal, and recurrence. Most wounds healed by secondary intention and were managed using simple tap water-moistened plain gauze dressings changed three times a day.ResultsFrom 1979 through 2014, 122 patients (56 men and 66 women), median age 38, underwent 245 operations for hidradenitis suppurativa. Patients underwent from 1 to 10 procedures; 61 patients (50%) underwent two or more procedures; and 26 (21%) underwent three or more. Wound sizes at operation ranged from quite small to over 1500  cm2. Men were older ...
Source: World Journal of Surgery - Category: Surgery Source Type: research

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Huidi Tchero, Christian Herlin, Farid Bekara, Sergiu Fluieraru, Luc TeotIndian Journal of Dermatology, Venereology, and Leprology 2019 85(3):248-257 Hidradenitis suppurativa is a chronic inflammatory condition that affects skin regions bearing apocrine glands. Although hidradenitis suppurativa is difficult to treat and cure, the currently available treatments are directed toward managing the lesions and associated symptoms. This review presents an evidence-based outline of the available treatment options. We searched four electronic databases and extracted data from retrieved studies for qualitative or quantitative analys...
Source: Indian Journal of Dermatology, Venereology and Leprology - Category: Dermatology Authors: Source Type: research
This article is protected by copyright. All rights reserved. PMID: 30920653 [PubMed - as supplied by publisher]
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research
This article is protected by copyright. All rights reserved. PMID: 30916383 [PubMed - as supplied by publisher]
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research
Valent S, Wikonkál N Abstract Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicles, usually presenting after puberty on the apocrine gland-bearing areas of the body. It usually flares up periodically and can lead to a severe condition affecting the 20-40-year-old childbearing age group. HS occurs more commonly in women. The main clinical features consist of painful, cicatrizing nodules and abscesses which develop mostly in the axillary, inguinal, genital and perianal regions and also on the breasts. HS is often accompanied by severe pain and malodorous discharge, both of which ca...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
Authors: de Haan JB, Hernandez N, Sen S Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the terminal hair follicle of the apocrine gland-bearing skin, presenting with inflamed nodules, abscesses, and sinus tracts. Autoimmune, genetic, and infectious factors have been implicated in its pathogenesis. HS can be managed medically using topical and systemic antibiotics and with tumor necrosis factor antibody therapy in severe cases. Surgical treatment can range from local excision, deroofing or excision of sinus tracts, or wide radical excision of severe lesions. Lesions can be severely painf...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
CONCLUSIONS: Inpatients with HS had increased odds of comorbid mental health disorders, overall, and multiple primary mental health admissions, in particular, which were associated with considerable excess costs. This article is protected by copyright. All rights reserved. PMID: 30422314 [PubMed - as supplied by publisher]
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research
ConclusionsInpatients with HS had increased odds of comorbid mental health disorders, overall, and multiple primary mental health admissions, in particular, which were associated with considerable excess costs.This article is protected by copyright. All rights reserved.
Source: British Journal of Dermatology - Category: Dermatology Authors: Tags: Original Article Source Type: research
Authors: Vellaichamy G, Braunberger TL, Jones JL, Peacock A, Nahhas AF, Hamzavi IH Abstract Hidradenitis suppurativa, also known as acne inversa, is a chronic recurrent inflammatory disease of the skin making management challenging and continuously evolving. A large number of modalities exist aimed at quantifying the efficacy of treatment in studies on hidradenitis suppurativa. Both physician-reported and patient-reported outcomes are used as endpoints in these studies; however, the vast majority of the modalities used to survey these reported outcomes lack validation and congruence between studies. Heterogeneity o...
Source: Giornale Italiano di Dermatologia e Venereologia - Category: Dermatology Tags: G Ital Dermatol Venereol Source Type: research
Hidradenitis suppurativa (HS) is a chronic, inflammatory, follicular disorder which presents with significant treatment challenges, largely in part because the pathogenesis is not well understood. While there are many new and emerging therapies, HS flares often remain difficult to control, and concerns of infection throughout the disease course remain prominent. Ertapenem use in HS represents a novel therapy. A recent study found significant improvement in pain and drainage of HS lesions following six weeks of daily intravenous (IV) infusion through a peripherally inserted central catheter.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
We report the case of a patient suffering from hidradenitis suppurativa since puberty and complaining of chronic low back pain associated to altered sensitivity and muscular weakness in the right leg. A diagnosis of lumbosciatica was confirmed. Symptoms were not relieved after the use of nonsteroidal anti-inflammatory drugs and analgesics. A surgical decompression was then indicated but heavily debated. Indeed, extended inflammatory and fibrotic hidradenitis suppurativa lesions were located regarding the skin area eligible for the proposed surgery. A combined therapy with clindamycine/rifampicin was started and the surgery...
Source: Case Reports in Dermatology - Category: Dermatology Source Type: research
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